Getting My Medicine
Molina Healthcare of Florida uses a Preferred Drug List (PDL), which is a list of covered prescription drugs. It is reviewed and approved by doctors and pharmacists. You must get your prescriptions from a pharmacy that is part of the Molina plan.
Generic drugs must be used when available. There are drugs that may have a limit on how much you can get at one time and its strength. Sometimes you have to try other medications first before we approve a drug. This is called Step-Therapy.
Your doctor knows about:
- The drugs on the Preferred Drug List.
- The drugs that need prior approval.
- How to process special requests.
Florida Medicaid Preferred Drug List (PDL)
Please click here for the Preferred Drug List (PDL).
Your doctor will get prior approval for the drugs that need it. Your doctor may want to give you a drug that is not on the PDL. Your doctor will ask for an approval through Molina's Pharmacy Department. We will reply to your doctor in two (2) days. If the request is approved, we will tell your doctor. If a request is denied, a letter will be mailed. The letter will tell you the reason for the denial. The letter will let you know how to appeal.
You may be taking a drug that is no longer on our PDL. Your doctor can ask us to keep paying for this drug by requesting a prior approval. The drug must be safe and help you with your medical problem.
There are drugs that are not covered, for example some drugs for weight loss or cosmetic purposes. You may want to know the list of drugs that are covered. Call Member Services.
You may call Member Services to get the following:
- A copy of the Preferred Drug List
- Information about drugs
- Find out if a drug is covered
- Find out how to appeal a decision
Your doctor will work with Molina to decide which drugs are best for you.
Pharmacies
Molina Healthcare of Florida has contracts with certain pharmacies. You must get your drugs at one of these pharmacies. Click here to Find A Pharmacy closest to you.
Mail Service Pharmacy
Molina wants to offer a time saving way to get your medicine. You can get a thirty-four (34) day supply on most drugs and up to one hundred (100) day supply on certain drugs. This is a great benefit. It is easy and can save you time. You don't have to go the pharmacy every month. If you want more info, call the Member Services Department at 1-866-472-4585 (TTY: 711). They can help you sign up.
Getting an exception to the PDL
Drugs not listed on the PDL are called non‐formulary drugs. For non‐formulary drugs, you have the following options:
- You can ask your physician to order a similar drug that is listed in the PDL.
- You can ask your physician to request an exception so your non‐formulary drug can be covered by your benefit.
- You can start the request for exception for a non‐formulary drug.
- If you want to start the exception process, you can call Member Services or complete the form below.
Member Exception Form
Statewide Medicaid Managed Care (SMMC) Program Over-the-Counter Benefit (OTC)
Molina Healthcare of Florida offers a $25.00 over-the-counter (OTC) benefit per household per month. This is for specific over-the-counter items purchased at a pharmacy that is part of Molina. To get more info, call our Member Services Department at 1-866-472-4585 (TTY: 711).
Psychotropic Drugs
Molina will not pay for some drugs prescribed to a child under the age of thirteen (13), without a signed consent form from the parent or guardian. Your doctor must keep a copy of the form in your child’s medical record. You or the doctor will need to give the pharmacy the signed form with a copy of the prescription.
The pharmacy will not fill this medicine for your child without the completed form. A new form must be given to the pharmacy with every new prescription.
If you have any questions about these drugs, please ask your doctor. If you want to know the list of medicines that must have a consent form, call Member Services.
Adobe Acrobat Reader is required to view the file(s) above. Download a free version.MMA and LTC Service Areas
*Region 8 Counties: Charlotte, Collier, De Soto, Glades, Hendry, Lee, Sarasota
*Region 11 Counties: Miami-Dade, Monroe
*Region 4 Counties: Baker, Clay, Duval, Flagler, Nassau, St. Johns, Volusia
*Region 5 Counties: Pasco, Pinellas
*Region 7 Counties: Brevard, Orange, Osceola, Seminole
If you have difficulty in reading or understanding this information, please contact Molina Healthcare Member Services toll free at (866) 472-4585, TTY at 711 for help. This information can be provided orally in English, or in your primary language. Written translations may be available in certain languages and accommodations will be made for the visually impaired.
Please note: If you have a disability and need more help, we can help you. If you need someone that speaks your language, we can also help. You may call our Member Services Department at 1-866-472-4585 for more help from 8:00 a.m to 7:00 p.m. If you are blind or have trouble hearing or communicating, please call 711 for TTY/TTD services. We can help you get the information you need in large print, audio (sound), and braille. We provide you with these services for free.
Tenga en cuenta lo siguiente: Si tiene una discapacidad y necesita más ayuda, podemos ayudarlo. Si necesita una persona que hable su idioma, también podemos ayudarlo. Puede llamar a nuestro Departamento de Servicios para Miembros al 1-866- 472-4585 para recibir más ayuda, de 8:00 a. m. a 7:00 p. m. Si es ciego o tiene problemas de audición o para comunicarse, llame al 711 para servicios de TTY/TTD. Podemos ayudarlo a obtener la información que necesita en letra grande, audio (sonido) y braille. Le brindamos estos servicios en forma gratuita.
Veuillez noter: Si vous avez un handicap et vous avez besoin plus d'aide, nous pouvons vous aider. Si vous avez besoin de quelqu'un qui parle votre langue, nous pouvons vous aider aussi. Vous pouvez appeler le Service aux Membres au 1-866- 472-4585 entre 8:00 a.m. et 7:00 p.m pour obtenir plus d'assistance. Si vous êtes aveugle ou si vous avez des problèmes auditifs, veuillez appeler 711 pour les services TTY/ATS. Nous pouvons vous aider à trouver l'information dont vous avez besoin en gros caractères, audio (son), et braille. Nous vous fournissons ces services gratuits.
Nota: siamo in grado di offrire ulteriore assistenza agli associati con disabilità. Ove necessario, è possibile richiedere l’intervento di un addetto che parli la lingua dell’associato. Per ulteriori informazioni è possibile chiamare il nostro Dipartimento dei servizi per gli associati (Member Services Department) al numero 1-866-472-4585 dalle ore 8:00 alle 19:00. Gli associati non vedenti, ipovedenti, non udenti o con difficoltà di comunicazione possono usufruire dei servizi TTY/TTD (trasmissione telefonica di testo/dispositivi di telecomunicazione per non udenti) resi disponibili tramite il numero 711. Siamo in grado di fornire le informazioni necessarie in formato di stampa a caratteri grandi, in formato audio (sonoro) e braille. Questi servizi sono fruibili gratuitamente.
Veuillez noter : si vous avez un handicap et besoin d’une aide supplémentaire, nous pouvons vous aider. Si vous avez besoin de quelqu’un qui parle votre langue, nous pouvons aussi vous aider. Vous pouvez appeler notre département de services aux membres au 1-866-472-4585 pour une aide supplémentaire de 8h00 à 19h00. Si vous êtes aveugle ou avez des troubles de l’audition ou de la communication, veuillez téléphoner au 711 pour les services de télécommunication à l’intention des malentendants. Nous pouvons vous aider à obtenir les informations dont vous avez besoin en grands caractères, sous forme audio (sonore) et en braille. Nous fournissons ces services gratuitement.
Обратите внимание: Мы помогаем лицам с ограниченными способностями или тем, кому требуется дополнительная помощь. Если вам требуется лицо, говорящее на вашем языке, мы также можем помочь. Для получения дополнительной информации вы можете связаться с отделом обслуживания участников программы по телефону 1-866-472-4585 с 08:00 до 19:00. Если у вас есть нарушения зрения, слуха или речи, позвоните по номеру 711 для связи по телетайпу/текстовому телефону. Мы можем предоставить вам необходимую информацию крупным шрифтом, в аудиоформате или шрифтом Брайля. Данные услуги предоставляются бесплатно.
Spanish
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-472-4585 (TTY: 711).
French Creole
ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. (Haitian Creole) Rele 1-866-472-4585 (TTY: 711).
Vietnamese
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-866-472-4585 (TTY: 711).
Portuguese
ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-866-472-4585 (TTY: 711).
Chinese
注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-866-472-4585（TTY：711）。
French
ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-866-472-4585 (TTY : 711).
Tagalog
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-866-472-4585 (TTY: 711).
Russian
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-866-472-4585 (телетайп: 711).
Arabic
ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم 1-866-472-4585 رقم.(711( :والبكم الصم ھ
Italian
ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-866-472-4585 (TTY: 711).
German
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-866-472-4585 (TTY: 711).
Korean
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-866-472-4585 (TTY: 711) 번으로 전화해 주십시오.
Polish
UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-866-472-4585 (TTY: 711).
Gujarati
સચુ ના: જો તમે ગજુ રાતી બોલતા હો, તો નન:શલ્ુ ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો 1-866-472-4585 (TTY: 711).
Thai
เรียน: ถ้าคุณพูดภาษาไทยคุณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี โทร 1-866-472- 4585 (TTY: 711).